Organization
BLANDFORD PHARMACY
Active
Other names
BLANFORD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH SHOLES (OWNER PHCST)
(501) 664-4466
Entity
Organization
Contact information
Practice address
5 SAINT VINCENT CIR, STE 110, LITTLE ROCK, AR 72205-5412
(501) 664-4466
(501) 664-2360
Mailing address
5 SAINT VINCENT CIR, STE 110, LITTLE ROCK, AR 72205-5412
(501) 664-4466
(501) 664-2360
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
AR13283
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110965407
—
AR
01
—
1994349
PK
—
Enumeration date
11/07/2006
Last updated
03/20/2017
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